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Maddy - GI II Exam I - some pharm > Path - Stomach > Flashcards

Path - Stomach Flashcards

1
Q

early and late sx of gastric adenocarcinoma

A

early: dyspepsia, dysphagia, and nausea
late: weight loss, anorexia, early satiety, anemia, hemorrhage

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2
Q

KIT tyrosine kinase and PDGFRA gain of function mutation

A

gastrointestinal stromal tumor (GIST)

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3
Q

irregular enlargement of the gastric rugae in the body and fundus, glands elongated with corskcrew like appearance w/ cystic dilation

A

menetrier dz

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4
Q

t(11:18)(q21:21) translocation

A

MALToma

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5
Q

H. pylori inducing inflammation which triggers NF-KB activation through MLT-BCL-10, leading to ______

A

MALToma

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6
Q

symptoms of jejunum and ileum carcinoid tumors

A

asymptomatic, obstruction, metastatic dz

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7
Q

compare acid production of H. pylori gastritis and autoimmune gastritis

A

H. pylori: increased or normal

autoimmune: decreased

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8
Q

diffuse atrophy, thinned mucosa in body and fundus, loss of rugal folds

A

autoimmune gastritis

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9
Q

mucosal inflammation with scant inflammatory cells

A

gastropathy

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10
Q

rare, improperly branched submucosal artery within the wall of the stomach that causes gastric bleeding

A

dieulafoy lesion

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11
Q

what are the precursor lesions of intestinal gastric adenocarcinoma

A

gastric dysplasia and adenomas

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12
Q

how does autoimmune gastritis cause neurological defects

A

autoimmune gastritis –> vitamin B12 deficiency –> degeneration of spinal cord, demyelination of spinal tracts –> paresthesia and numbness, memory loss

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13
Q

API2-MLT fusion protein

A

MALToma

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14
Q

location and size of stomach carcinoid tumors

A

body and fundus

- 1-2 cm

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15
Q

linitus plastica (leather bottle) gastric wall

A

diffuse gastric adenocarcinoma

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16
Q

sx of fundic gland polyps

A

none, nausea

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17
Q

symptoms of stomach carcinoid tumors

A
  • gastritis

- ulcer

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18
Q

local ischemia leading to upregulation of NO synthase and increased release of endothelin 1 (vasoconstrictor)

A

stress related gastric mucosal injury

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19
Q

compare location b/w menetrier disease and zollinger-ellison syndrome

A

menetrier: body and fundus

zollinger-ellison: fundus

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20
Q

sx of acute gastritis and gastropathy

A

may be asymptomatic or cause epigastric pain, nausea, vomiting
- more severe cases: mucosal erosion, ulceration, hemorrhage, hematemesis, melena, blood loss

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21
Q

longitudinal stripes of edematous erythematous mucosa alternating with less severely injured, paler mucosa

“watermelon stomach”

A

gastric antral vascular ectasia (GAVE)

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22
Q

solitary, well circumscribed fleshy masses, on cut surface shows whorled appearance

A

gastrointestinal stromal tumor (GIST)

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23
Q

how does H. pylori cause gastric injury

A

urease-secreting H. pylori inhibits gastric bicarbonate transporters by ammonium ions

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24
Q

sx of gastritis cystica

A

similar to chronic gastritis

nausea, upper abd pain, sometimes vomiting

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25
Q

germline loss of function mutation of CHD1

A

diffuse gastric adenocarcinoma

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26
Q

diffuse foveolar cell hyperplasia of the body and fundus due to overexpression of TGF-a

A

menetrier dz

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27
Q

most frequent complication of peptic ulcer dz

A

bleeding

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28
Q

behavior of jejunum and ileum carcinoid tumors

A

aggressive

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29
Q

list the protective factors of the gastric mucosa

A
  • surface mucus secretion
  • bicarbonate secretion
  • mucosal blood flow
  • epithelial barrier
  • epithelial regeneration capacity
  • prostaglandins
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30
Q

what patients are most likely to get stress ulcers

A

pts w/ shock, sepsis, or severe trauma

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31
Q

compare association w/ adenocarcinoma b/w menetrier disease and zollinger-ellison syndrome

A

menetrier: associated

zollinger-ellison: not associated

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32
Q

disease associations with stomach carcinoid tumors

A
  • atrophic gastritis

- MEN1

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33
Q

secretory products of stomach carcinoid tumors

A
  • histamine
  • somatostatin
  • serotonin
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34
Q

sx of inflammatory and hyperplastic polyps

A

similar to chronic gastritis

nausea, upper abd pain, sometimes vomiting

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35
Q

where can acute stress ulcers be found

A

ANYWHERE in the stomach

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36
Q

ulcers in the proximal duodenum associated with severe burns or trauma

A

curling ulcers

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37
Q

“salt and pepper” appearance of a tumor indicates

A

neuroendocrine tumor (carcinoid tumor)

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38
Q

sx of chronic gastritis

A

n/v and upper abd pain

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39
Q

how do NSAIDs cause gastritis

A

NSAIDs inhibit COX –> cannot make prostaglandins E2 and I2 –> can no longer stimulate defense mechanisms (HCO3-, mucus, phospholipids)

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40
Q

sharply punched out defect with over hanging mucosal borders and smooth, clean ulcer bases

A

peptic ulcer disease

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41
Q

list the injury-causing (not normal) damaging factors to the gastric mucosa

A
  • H. pylori
  • NSAIDs
  • tobacco
  • alcohol
  • gastric hyperacidity
  • duodenal-gastric reflux
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42
Q

tumor arising from diffusely distributed endocrine cells causing endocrine cell hyperplasia

A

carcinoid tumors (well differentiated neuroendocrine tumors)

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43
Q

sx of MALToma

A

dyspepsia and epigastric pain, possible hematemesis, melena, and weight loss

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44
Q

ulcers of PUD are most common where

A
  • proximal duodenum
  • near pyloric valve
  • anterior duodenal wall
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45
Q

ongoing gastric mucosal inflammation with mucosal atrophy

A

chronic gastritis

46
Q

compare symptoms b/w menetrier disease and zollinger-ellison syndrome

A

menetrier: hypoproteinemia, weight loss, diarrhea

zollinger-ellison: peptic ulcers

47
Q

demographic for autoimmune gastritis

A

median age 60 years, women > men

48
Q

what cells secrete mucin

A

surface foveolar cells

49
Q

hypergastrinemia and decreased pepsinogen due to destruction of chief cells

A

autoimmune gastritis

50
Q

(+) neuroendocrine markers

A

carcinoid tumors (well differentiated neuroendocrine tumors)

51
Q

compare associations of H. pylori gastritis and autoimmune gastritis

A

H. pylori: low socioeconomic status, poverty, rural areas

autoimmune: autoimmune disorder, thyroiditis, DM, grace’s

52
Q

yellow-tan intramural or submucosal masses leading to small polypoid lesions

A

carcinoid tumors (well differentiated neuroendocrine tumors)

53
Q

why are older adults more susceptible to gastritis

A

they have reduced mucin and bicarbonate secretion

54
Q

most common malignancy of the stomach

A

gastric adenocarcinoma

55
Q

mesenchymal tumor that arises from interstitial cells of Cajal

A

gastrointestinal stromal tumor (GIST)

56
Q

risk factors for gastritis cystica

A

trauma or prior surgery

57
Q

pathogenesis of autoimmune gastritis

A

CD4+ T cell destruction of parietal cells –> loss of HCL and IF production

58
Q

APC, TGF-B, BAX, CDKN2A loss of function mutations

A

intestinal gastric adenocarcinoma

59
Q

compare inflammatory infiltrate of H. pylori gastritis and autoimmune gastritis

A

H. pylori: neutrophils, subepithelial plasma cells

autoimmune: lymphocytes, macrophages

60
Q

where are MALTomas most often located

A

most commonly arise within tissues normally devoid of organized lymphoid tissue

61
Q

presence of neutrophils above the basement membrane in the GI tract indicates ____

62
Q

ulcer base that is brown to black (due to blood)

A

stress related gastric mucosal injury

63
Q

diffuse mucosal atrophy with prominent lymphoid aggregates

A

chronic H. pylori gastritis

64
Q

compare location of H. pylori gastritis and autoimmune gastritis

A

H. pylori gastritis: antrum

autoimmune: body

65
Q

which gastric polyps are associated with adenocarcinoma?

A
  • gastric adenomas
  • familial adenomatous polyposis
  • occasionally inflammatory and hyperplastic polyps
66
Q

autoantibodies against parietal cells and H+/K+ ATPase and if

A

autoimmune gastritis

67
Q

GI pain referring to the back, LUQ, and chest

A

peptic ulcer disease

68
Q

compare inflammatory infiltrate b/w menetrier disease and zollinger-ellison syndrome

A

menetrier: lymphocytes

zollinger-ellison: neutrophils

69
Q

CXR showing free air under diaphragm

A

perforation into the peritoneal cavity due to ulcer from PUD

70
Q

diagnostic testing for H. pylori gastritis

A
  • urea breath test (for ammonia production)
  • biopsies
  • fecal bacteria detection
  • serologic test for antibodies
71
Q

epigastric burning or aching pain that is worse at night and 1-3 hours after meals

A

peptic ulcer disease

72
Q

giant cerebriform enlargement of rugal folds due to epithelial hyperplasia without inflammation

A

hypertrophic gastropathies

73
Q

chronic mucosal ulceration of the lesser curve of the stomach at the antrum or proximal duodenum, associated w/ H. pylori and NSAIDs

A

peptic ulcer disease

74
Q

where are most gastric adenocarcinomas found

75
Q

where does H. pylori most often affect

A

antrum of stomach

76
Q

compare mean patient age b/w menetrier disease and zollinger-ellison syndrome

A

menetrier: 30-60

zollinger-ellison: 50

77
Q

extranodal lymphoma arising anywhere in the GI tract as a result of chronic inflammation

A

MALToma

mucosa-associated lymphoid tissue

78
Q

erosion and hemorrhage in the setting of acute gastritis

A

acute erosive hemorrhagic gastritis

79
Q

most common mesenchymal tumor of the abdomen

A

gastrointestinal stromal tumor (GIST)

80
Q

what is the characteristic feature of acute gastritis

A

neutrophils

81
Q

associations with endocrine cell hyperplasia, vitamin B12 deficiency, and defective gastric acid secretion

A

autoimmune gastritis

82
Q

causes of gastropathy

A
  • NSAIDs
  • ETOH
  • bile
  • stress-induced injury
  • portal HTN
83
Q

describe the state of the gastric mucosa in an ulcer

A
  • loss of mucus, mucosa, and muscularis mucosae

- layer of necrosis –> inflammation –> granulation tissue –> fibrotic scar (NIGS)

84
Q

two types of hypertrophic gastropathies

A
  • menetrier dz

- zollinger-ellison syndrome

85
Q

increased Wnt signaling

A

intestinal gastric adenocarcinoma

86
Q

list the “normal” damaging factors to the gastric mucosa

A
  • gastric acidity

- peptic enzymes

87
Q

gastrin secreting tumors of the stomach, small bowel, or pancreas

A

zollinger-ellison syndrome

88
Q

how does erosion occur in acute gastritis

A

neutrophils invade the epithelium causing superficial epithelial sloughing

89
Q

what is the “carney triad”

A

seen in young females

  • GIST
  • paraganglioma
  • pulmonary chondroma
90
Q

associated w/ pernicious anemia

A

autoimmune gastritis

91
Q

ulcers in the esophagus, stomach, and duodenum that are associated with increased intracranial pressure

A

cushing ulcer

92
Q

histo: intraepithelial and luminal neutrophils forming pit abscesses

A

H. pylori gastritis

93
Q

compare gastrin levels of H. pylori gastritis and autoimmune gastritis

A

H. pylori: normal to decreased

autoimmune: increased

94
Q

most common cause of chronic gastritis

A

H. pylori

second is autoimmune gastritis

95
Q

histo: foveolar cell hyperplasia and corkscrew profiles and epithelial proliferation

A

gastropathy and acute gastritis

96
Q

pathogenesis of cushing ulcer

A

increased intracranial pressure leads to direct stimulation of vagal nuclei leading to hypersecretion of gastric acid

97
Q

sx of gastric adenomas

A

similar to chronic gastritis

nausea, upper abd pain, sometimes vomiting

98
Q

imbalances between mucosal defense mechanisms and damaging factors that cause chronic gastritis

A

peptic ulcer disease

99
Q

secretory products of jejunum and ileum carcinoid tumors

A

serotonin, substance P, polypeptide YY

100
Q

compare acute gastritis and gastropathy

A

acute gastritis: neutrophils

gastropathy: rare or absent inflammatory cells

101
Q

causes of gastric antral vascular ectasia (GAVE)

A

idiopathic or associated with cirrhosis or sclerosis

102
Q

risk factors for gastric adenomas

A

chronic gastritis, atrophy, intestinal metaplasia

103
Q

tx for MALToma

A

combination antibiotic therapy

104
Q

what stain diagnoses chronic gastritic

A

warthin-starry stain

105
Q

risk factors for peptic ulcer dz

A
  • h. pylori
  • tobacco use
  • COPD
  • illicit drugs
  • NSAIDs
  • alcohol cirrhosis
  • stress
106
Q

compare serology of H. pylori gastritis and autoimmune gastritis

A

H. pylori: antibodies to H. pylori

autoimmune: antibodies to parietal cells and intrinsic factor

107
Q

diagnostic lymphoepithelial lesions in antrum w/ spiral organisms

A

MALToma w/ H. pylori

108
Q

non-tender mass in supraclavicular fossa indicates ____

A

gastric adenocarcinoma

109
Q

CDH1 loss of function

A

gastric adenocarcinoma

110
Q

signet ring cells on histo

A

gastric adenocarcinoma

Maddy - GI II Exam I - some pharm (23 decks)

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